Health Care Reform Reax

Let me offer a ludicrously premature opinion: Barack Obama has sealed
his reputation as a president of great historical import. We don't know
what will follow in his presidency, and it's quite possible that some
future event--a war, a scandal--will define his presidency. But we do
know that he has put his imprint on the structure of American
government in a way that no Democratic president since Lyndon Johnson
has.

If Republicans succeed  if they govern successfully in office and
negotiate attractive compromises out of office  Rush’s listeners get
less angry. And if they are less angry, they listen to the radio less,
and hear fewer ads for Sleepnumber beds.

So today’s defeat for free-market economics and Republican values is
a huge win for the conservative entertainment industry. Their listeners
and viewers will now be even more enraged, even more frustrated, even
more disappointed in everybody except the responsibility-free talkers
on television and radio. For them, it’s mission accomplished. For the
cause they purport to represent, it’s Waterloo all right: ours.

I have been
trying to explain to my youngest why this is such an exciting moment:
front line soldiers in Afghanistan and Iraq take personal risks, put
their lives on the line. But so few politicians put their careers on
the line, even though they make decisions that have an impact on
soldiers. President Obama (and to some degree every Democrat who
supports this bill) is putting his political career on the line. The
idea that you might do what you think is right and pay a penalty has
been so foreign to politics that it surprises us when we see it. I
think my son is surprised to hear all this. He assumes at 12 years of
age that people, especially people we elect, go to Washington to do the
right thing.

What I hope is that the Democrats take a beating at the ballot box and rethink their contempt for those mouth-breathing illiterates in the electorate. I hope Obama gets his wish to be a one-term president who passed health care. Not because I think I will like his opponent--I very much doubt that I will support much of anything Obama's opponent says. But because politicians shouldn't feel that the best route to electoral success is to lie to the voters, and then ignore them.

I don't think anyone will hold up the bill that will pass as
exemplary, but it does reflect elements of health care reform that
Democrats campaigned on and won on in 2008. So I have a hard time seeing
this as doing violence to the will of the people as it is typically
expressed in our electoral system. Elections matter. This is how they
matter.

Do not believe anyone who tells you they understand the path American
politics will take after this vote. It is truly unique. And yet a few
things are clear. One, the idea of the "pro-life" Democrat should be
tossed into the dust-heap along with such outmoded concepts as
cold-fusion. Two, Obama will achieve a short-term bump in his political
capital, and likely his poll ratings, because he will have achieved
something that every Democratic president since Harry Truman has been
unable to accomplish. And three, Obamacare is a testable proposition.
The proponents of this legislation have made distinct claims regarding
its costs and consequences that should not be forgotten -- especially
when America encounters its first debt crisis some years from now.

The oddest thing about the health care debate, at least in my view, is
that Republicans basically did not engage on the actual substance of
the bill. Lots of stuff about death panels, and lots of stuff about
procedure, lots of stuff about backroom deals (most of which will be
gone after reconciliation) but shockingly little about the individual
mandate -- or, as Tim Noah points out, about the actual taxes
that really are being raised for this. The only real substantive
complaint they highlighted was Medicare, where they argued against
their own position.

Democrats are going to stress the parts of the bill that kick in
immediately, including small business tax cuts, closing the Medicare
donut hole, allowing adult children up to the age of 26 to stay on
their parents' health care plans, insurance industry reforms (ending
recissions), free preventative, and temporary coverage for early
retirees, among others.

Large-scale change naturally provokes anxiety, uncertainty, fear and
resistance, which is inevitable and as it should be. It does not follow
that the later backlash against large-scale change will be great enough
to undo the change. The Medicare prescription drug benefit was not
passed by large margins in the House, and its eventual passage was the
product of some significant arm-twisting, maneuvering and vote-buying.
It was also unfunded and therefore incredibly fiscally irresponsible!
It was phenomenally bad policy! That doesn’t mean that there has been a
groundswell of outraged voters ready to support its repeal. As far as I
know, no one on the mainstream right, least of all the editor of the
magazine that once championed big-government conservatism, has even
proposed repealing it. After all, it is their monstrosity. It has
become part of the structure of our unsustainable, disastrous
entitlement system, and no politician with any self-preservation
instinct would so much as suggest eliminating a benefit that millions
of likely voters enjoy receiving.

The Democrats won that battle because they said to themselves and
the country: on this ground we're willing to lose. And in addition to
all the hard work and everything else in their favor, that commitment
stiffened their spines and made them credible to the public at large.
It made the political victory possible.

A genuine willingness to lose means just that: you might lose. You
might lose big. And the dynamics of a mid-term election, amidst
crippling unemployment and an energized right, have certain unavoidable
implications. But I suspect the effect for the Democrats of actual
passing this legislation will be considerably more positive than people
realize.

I’ve been saying for many months that if healthcare reform passes, I
believe that Obama, for all of his myriad flaws, will be the best
President of my lifetime and one of the ten best in the nation’s
history.

To a significant extent, Ms Pelosi is viewed negatively because
Americans think of her as a loser. This impression is understandable
when you look at the way mainstream media have covered this Congress,
but it's utterly misplaced. She has presided over one of the most
effective sessions in the history of the House [and she has] emerged the
victor in the bloodiest battle America's legislature has seen since the
impeachment of Bill Clinton, if not longer. Maybe people (Democrats, at
least) will finally start giving her the credit she deserves.

Now that it’s done, Barack Obama will go down in history as one of America’s finest presidents. It’s always possible
of course that, like LBJ, he’ll get involved in some unrelated fiasco
that mars his reputation. But fundamentally, he’s reshaped the policy
landscape in a way that no progressive politician has done in decades.

Make no mistake: the more virulent GOP opposition to the plans became -
and, if you like, the more hysterical - the more Democrats had to pass
it if only to save face. Sceptical Blue Dogs, Pro-Lifers and Leftists
were all forced to club together for the greater good of the party.
Left to their own devices they almost certainly couldn't have agreed on
a bill, any bill.

In the end, perhaps the greatest thing going for this bill is the
possibility that it will open future avenues for better reforms down
the road. That is not a very compelling argument, of course, but who
knows? It may in fact be the most important argument of them all. The
future will demand reform, and we may as well begin the process.

(Image: Lights are on at the US Capitol as the House of
Representatives works during a rare Sunday session on March 21, 2010 in
Washington, DC. By
Mark Wilson/Getty Images.)

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